In September of last year, Mesothelioma Guide reported on a new, potentially life-extending drug to treat mesothelioma, defactinib. The drug, sponsored by the pharmaceutical company Verastem, inhibits the ability of mesothelioma stem cells from spreading and forming new tumors.

Verastem announced clinical trial locations back in September, but only recently were locations announced in the U.S. This means eligible patients with malignant pleural mesothelioma may now participate in the study. Participation in the study not only supports the advancement of research but also has the potential to significantly increase a patient’s prognosis.

The study is a registration directed trial known as COMMAND (Control of Mesothelioma with MAiNtenance Defactinib) and is currently is the second phase of clinical trials.

Patients participating in the study are only required to take two pills of defactinib a day as well as blood and other lab tests to assess the efficacy of the drug. Because this is a clinical trial, patients also receive the benefit of being treated at no cost.

Defactinib is an inhibitor of the signaling pathways for cancer stem cells. By interrupting communication between these stem cells, metastasis is hindered and cancer cell death is induced.

Locations and Eligibility

There are currently 28 trial locations across the globe, seven of which are in the United States. Cancer centers in the U.S. participating in the trials include:

  • Johns Hopkins Sidney Kimmel Cancer Center (Baltimore, MD)
  • Memorial Sloan Kettering Cancer Center (New York, NY)
  • University of Chicago Medical Center (Illinois)
  • Jacobi Cancer Center (Bronx, NY)
  • Cleveland Clinic (Ohio)
  • Abramson Cancer Center (Philadelphia, PA)
  • UT Southwestern (Dallas, TX)

The research supporting defactinib as maintenance therapy for pleural mesothelioma patients holds the potential not only improve the quality of life for patients but also extend life. Taking part in this trial is currently the only way to receive this treatment. Eligibility for this trial comprises four key criteria.

  • 1
    The patient must have completed chemotherapy treatment with Alimta combined with a platinum-based chemotherapy drug (cisplatin or carboplatin). Alimta and cisplatin are considered the only effective standard chemotherapy treatment.
  • 2
    The patient must have received Alimta and cisplatin as their first line of chemotherapy treatment.
  • 3
    The patient’s mesothelioma must be stable or reduced after chemotherapy. Essentially, the patient’s tumor must not be spreading.
  • 4
    The patient must be willing to give a sample of their tumor for biomarker research. Biomarkers are diagnostic tests that hold the potential diagnose mesothelioma earlier.

Maintenance Treatment of Mesothelioma

This clinical trial of defactinib is particularly exciting because it offers the potential for maintenance treatment of mesothelioma. There is no standard for maintenance treatment of mesothelioma currently, so it’s likely some people aren’t familiar with the term.

For those unfamiliar, maintenance treatment takes place after the first line of treatment, which is typically the combination of chemotherapy drugs, Alimta and cisplatin. After several cycles of chemotherapy, a patient’s cancer growth may be stopped or reduced, but maintenance treatment is needed to keep the cancer from spreading again.

The lack of a standard maintenance therapy for mesothelioma contributes to the low life expectancy attributed to the disease. However, defactinib is one of the first drugs that has shown so much potential to improve the overall survival of mesothelioma patients. If you or a family member are eligible for this clinical trial, it may serve to add months or years to your prognosis.

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    About the Writer, Andrew Devine

    Andrew Devine is a contributing writer for Mesothelioma Guide. He has developed an interest in educating patients and their families on everything from new treatments to what to expect after diagnosis.